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Sunday, 7 November 2010

All Drugs Are Not The Same

People love drugs … this is a fact. And many people will use drugs. Another fact.

Some will overdose, some will get sick and some will want to go home, But the vast majority will get what they paid for … a hellava’ good time. Yeah, yeah, I hear you - drugs are bad, drugs can hurt you - but so can anal sex but that act is performed at least a million times a year without a lot of complaints.

Funny enough, the same people who complain about others having anal sex also complain about drugs. You know the type I mean. Arrogant, conservative, self-righteous, self-important, self-appointed guardians of all things moral. They use jargon like “family values”, “personal responsibility”, “do the crime … do the time” or remind us that things were different in 1956. They were once called wowsers.

Wowser

[noun] Austral./NZ informal - a person who is publicly critical of others and the pleasures they seek; a killjoy

One common mistake made by wowsers / the media / the government / anti-drug zealots / the police / moral crusaders etc. is lumping all drugs together under the one umbrella. You often hear the police blame someone’s actions on being “under the influence of drugs” or the media describe erratic behaviour due to drugs. On Channel 7’s, The Force - Behind the Line, I heard one police officer describe a suspect as showing typical signs of drug use - hyperactive, extremely restless, nervous and pinpoint pupils. What drug causes that? The victim was caught with speed which explains most of the symptoms except pinpoint pupils are typical of heroin use not speed. Amphetamines(speed) make your pupils bigger, not smaller. This is a classic example of how all drugs are lumped into one category.

But, all drugs are not the same. Some people perceive them to be like different kinds of liquor. e.g. whisky, beer, wine, cognac. They all look and taste differently but the effect is the same … you get stoned. Drugs though, offer a rich variety of effects, some of which can be compared to activities in the physical world. Jumping out of an aeroplane might thrill the adrenaline junkies but it doesn’t even come close to what first hooked a heroin addict. Being as cool as James Bond involves years of practice, exercise and training but why bother when a line of coke can give you same confidence? What about sex? Option one - Seven years in India learning the Karma Sutra, four years of attending the gym followed by two years of studying Men are from Mars, Women are from Venus, The 5 Love Languages: The Secret to Love That Lasts or even A Couple’s Guide to Automobile Repairs. Option two - an ecstasy pill.

Another common misrepresentation is that unhappy people turn to drugs to dampen their emotional pain. That’s like saying all drinkers “hit the booze” to “drown their sorrows”. Of course, most drinkers indulge in alcohol because it’s enjoyable and it’s no different with drugs. And which “drugs” do they turn to? I find it hard to imagine that someone with a great burden on their shoulders will turn to ecstasy to block out the world. Or someone with suicidal tendencies overdosing themselves on pot in a half hearted attempt to end it all. I turned to heroin after the death of my wife when booze wasn’t killing me quickly enough or dampening the unbearable sorrow I was feeling. Before then, I had only used drugs like speed to enhance my night out or to experience the trippy pleasures of mushrooms, LSD and dope. The point is, I turned to a particular drug like heroin, not ice, weed or cocaine. Who knows what might have happened if I took up LSD instead of heroin?

What attracts people to different types of drugs? My experience is that people want certain drugs for different reasons. Alcohol is for socialising, dope is for chilling out, speed/ice/cocaine for partying, LSD/mushrooms for experimenting and heroin for multiple reasons. But according to many sources like the media, it’s irrelevant because … drugs are bad, mmkay!

This blanket approach to drugs has been enforced around the globe for the last 100 years. Now when any new drug appears on the market, it gets slotted under the “drugs” umbrella without any scientific examination or analysis of it’s social effect. Ecstasy(MDMA) is a classic example of how an over zealous organisation like the US Drug Enforcement Agency (DEA) ignored all input from medical / scientific groups and pushed for a schedule I drug classification. This was despite a court ruling that it should not be banned, advice from medical experts and the successful trials that showed it to be a possible treatment for PTSD, depression and other disorders. The DEA used it’s special authority granted by the government to override the court’s decision, ignore scientific advice and make it’s own judgement. MDMA was banned and classed as a schedule I drug.

US Schedule I Drug:

(A) The drug or other substance has a high potential for abuse.

(B) The drug or other substance has no currently accepted medical use in treatment in the United States.

(C) There is a lack of accepted safety for use of the drug or other substance under medical supervision

Many countries including Australia now just mimic any scheduling decisions made by the US and the UK. Not surprisingly, the only exception is when they lower the classification of a drug. It would have been interesting to see what happened if Proposition 19 in California was passed and cannabis became legal. If the example of how Australia managed the classification of UK legal highs or MDMA is any thing to go by, then we are doomed to retain only stricter scheduling of drugs but ignore any changes that reflect a loosening of restrictions.

But it’s not just government classifications that get the blanket treatment. The scheduling of drugs is also driven by how society views these substances. And this is where the sensationalist media and political rhetoric comes into action. These potent forces have been pumping disinformation into us for decades and now much of the public believes their spin. And why wouldn’t they? Just mention heroin or crack and watch instantly as normal, rational human beings turn into judgemental, irrational zealots. Try pointing out the facts and watch as disbelief overrides all evidence and reality. Listen up to the amazing array of myths that will used to attack your “extremist” views. Why is it is so damned hard to expose decades of propaganda from the government, anti-drug nutters and the media.

Just recently, Professor David Nutt was sacked from the the Advisory Council on the Misuse of Drugs (ACMD), who are a group of scientists, academics and doctors commissioned by the UK government to advise on drug policy. His crime was telling the truth. Prof. Nutt was simply providing evidence that some drugs like cannabis, LSD, mushrroms and ecstasy(MDMA) are much safer, and that alcohol is far more dangerous, than the official government position or the public’s perception. The UK Home Secretary decided that maintaining flawed information about drug harms was more important than the facts so he sacked Prof. Nutt claiming he was out-of-line for criticising government policy. Can you imagine any other scientific issue that would prompt a government to dismiss the evidence and remain fooling the public with flawed information?

Professor David Nutt has since created his own group called, the Independent Scientific Committee on Drugs. Last week, they published a scientific paper in the respected Lancet medical journal that measured the rates of harm from illicit drugs, alcohol and tobacco. The results showed that alcohol is the most dangerous drug in the UK, overshadowing heroin and cocaine. At the other end of the scale, mushrooms, ecstasy and LSD were well down the list. As expected, the report has caused a frenzy of newspaper articles.

Background

Proper assessment of the harms caused by the misuse of drugs can inform policy makers in health, policing, and social care. We aimed to apply multicriteria decision analysis (MCDA) modelling to a range of drug harms in the UK.

Methods

Members of the Independent Scientific Committee on Drugs, including two invited specialists, met in a 1-day interactive workshop to score 20 drugs on 16 criteria: nine related to the harms that a drug produces in the individual and seven to the harms to others. Drugs were scored out of 100 points, and the criteria were weighted to indicate their relative importance.

Findings

MCDA modelling showed that heroin, crack cocaine, and metamfetamine were the most harmful drugs to individuals (part scores 34, 37, and 32, respectively), whereas alcohol, heroin, and crack cocaine were the most harmful to others (46, 21, and 17, respectively). Overall, alcohol was the most harmful drug (overall harm score 72), with heroin (55) and crack cocaine (54) in second and third places.

Interpretation

These findings lend support to previous work assessing drug harms, and show how the improved scoring and weighting approach of MCDA increases the differentiation between the most and least harmful drugs. However, the findings correlate poorly with present UK drug classification, which is not based simply on considerations of harm.

What this report doesn’t cover though, is how these drugs would rate in a world without prohibition. By far, most problems from drug use is attributed to our drug laws. It’s the illegality of these substances that causes more damage than the drugs themselves. Heroin, for example is basically non toxic and can taken for decades without much physical damage. Cocaine, speed and GHB taken occasionally will not greatly impact on your health unless of course, it’s cut with drain cleaner. Smoking naturally grown cannabis in moderation will not usually hurt any adult who doesn’t have a history of mental health disorders. Popping an ecstasy pill (pure MDMA) every few months is not going send most people to rehab. Although moderation is the best defence against the potential, nasty side effects of illicit drug use, prohibition is the real culprit. Prohibition removes all the safe guards that could be included with regulated sales of these drugs. Prohibition puts the safety of drug users in the hands of criminals and dealers who offer no quality control or age restrictions. Even that junkie stereotype is purely a result of drugs being illegal. It’s not the drugs that make junkies look skinny, dirty and homeless - it’s the desperation from dodging police, being maligned by the public and that never ending search for money that leaves very little for rent, food etc.

For many, their deep-seated views on drugs are not going to change anytime soon. Most of the population has never experienced a world without drug prohibition and after a lifetime of misinformation and the constant drone of anti-drug sentiment, the demonising of drugs has been very effective. Separating substances into groups based on their harm might go a long way to educating the public and hopefully provide some sanity in the drug debate. We don’t want a repeat performance of Liberal hack, Chris Pyne dribbling on about pot and heroin being equally as dangerous. These theatrical performances might appease dorks like Pyne but they do nothing to keep people safe. Nor does the popular trend of outing one’s self as having tried pot at university but declaring it’s now unsafe to do so because of the latest research. Over the last few years, we have had Australia’s top politicians admitting to smoking the evil weed but warning others not to follow suit. Julia Gillard, Tony Abbott, Wayne Swann and Malcolm Turnbull have all made this admission but it took the current US president to actually come clean. When asked if he “inhaled” - a reference to former US president who said he tried pot but didn’t inhale - Obama said, “that’s the point, isn’t it”.

We have to end the “drugs are bad … mmkay” mentality. All drugs have specific harms when abused but some, more than others. Inexperienced people shooting up hard drugs is not a good idea but overall, binge drinking causes more harm than intravenous drug use. Dozens of night-clubbers taking ecstasy in it’s pure form will not cause anywhere near the carnage inflicted by boozers in the same venue. Smoking pot each night for years on end will only produce a tiny group of dependant users compared to drinkers who consume similar amounts to achieve the same intoxication. And contrary to popular beliefs, methamphetamines like ice cause a fraction of the violence that alcohol bestows on the community each week.

These facts need to be explained to the public along with the truth about legal drugs like alcohol, tobacco and prescription medication. Although it’s changing slowly, all illicit drugs are still seen as something that only desperate, low life druggies will consider while incredibly, booze is considered a safe alternative. The facts are out there but if our leaders and the media are not prepared to tell us the truth then the public will remain victims of deceit and agenda driven policy. We deserve better.

15 comments:

"By far, most problems from drug use is attributed to our drug laws. It’s the illegality of these substances that causes more damage than the drugs themselves".

Terry I often read your column but rarely comment. Some of what you say is correct. Your line above has no evidence or intellectual base whatseover-overall.

Nutt did not get sacked for JUST having an opinion about drug legalisation, he got sacked for activity incompatible with his role as Chair of the ACMD and (just maybe) the partly the way he dealt with issues around benzos.

I fact the real truth about Nutt's current motives is probably that he is persuing a line to furher his own business interests.

In 2006, Nutt wrote an editorial in the Journal of Psychopharmacology (Editor D Nutt) in which he proposed the idea of asocial substitute for alcohol. (Possibly based on a benzo realted to the date rape drug Rohypnol), this was followed by an article by Robin Room suggesting that inventing this substance was not the problem, the problem lay in the classification system.

Since that last article Nutt has worked to overthrow the system (and got sacked for his trouble).

In 2007 he and Colin Blakemore with two others, presented an "Hierarchy of Harms" article in the Lancet, integrating legal and illegal drugs, this was done by "Delphic Analysis" basically asking a selected group what they thought. Many chose not to reply but he published anyway.

It was disrgarded by government.

This latest effort is along similar lines, duplicitous and flawed of course (and notably unscientific?) because it fails to deal adequately with prevalence. It may be more flawed than the earlier effort because of the selection of mainly Nutt mates and fellow travellers. It is very surprising the Lancet chose to publish it, the promotion of socially and personally harmful drugs, one might think, has nothing to do with the hippocratic oath.

Last time I checked Nutt had very large, seriously large, financial investments in at least one major pharmaceutical company and works closely with and is dependent for research grants from many others.

None of this means he does not have something valid to say, some of the time, it may mean he should have made a declaration of interest.

It certainly means that his campaining and his affiliation with odd ball crusading single issue legalisation outfits like the Beckley Foundation (where Amanda Neidpath who runs it believes in boring a hole in the skull), was incompatible whith his role at the ACMD.

He was rightly sacked. He is free to campaign as he does. He does not challenge what I say about his commercial motives, I have twice put it to him in public meetings. He is unable to respond.

I hope this history lesson has helped your perspective. You probably agree with Nutt but do not mislead your readership.

Why give out free/cheap heroin when you can create enough stress/mental illness to justify prescribing antidepressants and antipsychotics...Just like Monsanto control the GM soymarket in a very fascist..oh i mean capitalist way..the Pharmaceutical giants obviously know it's probably cheaper to medicate someone with a semi-synthetic that comes from a weed but they wouldnt be upholding their "corporate duty" which is to make as much damn cash as possible,regardless of the carnage and both human and environmental misery...Create mental illness ,call it petty crime ,jail the guilty,get yourself an "army of rightless people "happy" to do some prison work ... we people are just another commodity to buy n sell for this monster

"I fact the real truth about Nutt's current motives is probably that he is persuing a line to furher his own business interests."

Probably? This theory is implausible. Professor Nutt has sacrificed much for his advocacy and profited little. I'm sure he could profit a lot more if he spent his time on anything other than advocating for drug law reform.

"Last time I checked Nutt had very large, seriously large, financial investments in at least one major pharmaceutical company and works closely with and is dependent for research grants from many others."

Do you genuinely believe he has no better or easier way to make some money? I'm pretty sure he'd be richer right now if he had toed the government line...

"he got sacked for activity incompatible with his role as Chair of the ACMD"

Nothing he did was incompatible with the stated purpose of the ACMD. Nothing in the act establishing it's role demands it must enforce and advocate prohibition. It's supposed to be a public health body, and Nutt acted according to scientific research in these interests. He was sacked because his political masters prefer prohibition over harm minimisation, regardless of the consequences.

"duplicitous and flawed of course because it fails to deal adequately with prevalence."

I haven't read the paper in sufficient depth to analyse this claim. Can you link to a peer reviewed article that criticises Nutts research for this reason?In any case, much of Nutts research is solid on risk analysis, such as this article comparing horse riding to ecstasy use, and the relative risk involved: http://www.encod.org/info/EQUASY-A-HARMFUL-ADDICTION.htmlThis isn't something that would change with prevalence.

" It is very surprising the Lancet chose to publish it, the promotion of socially and personally harmful drugs, one might think, has nothing to do with the hippocratic oath."

In what way does any part of the article promote drug use?Modern medicine doesn't follow the hippocratic oath. There's a thing called 'autonomy'

Well said Cameron. It seems our anonymous friend is well known anti-drug campaigner, David Raynes. And like most things he writes, his comment was full of silly assumptions, cherry picked data and skewed bias.

Drugs are fucking fun. And the desire to change one's consiousness by means chemical or otherwise is clearly part of human nature. That is why the "War on Drugs" is both doomed and wrong.

And it really blows my mind that politicians can be so damned hypocritical... er, well, okay, perhaps I shouldn't so surprised... anyway... to be so damned hypocritical as to admit taking drugs yet not even raise the topic, let alone draft/repeal relevant legislation. Have they no shame? Is NO-ONE in either of the two major parties -- and frankly, the Greens seem to have chickened out too -- in the least bit concerned that their fellow citizens are sent to prison -- with all the bastardisation, rape etc that entails -- every year for drug-related crimes?

And furthermore... I don't know anyone who's gone to jail. One SINGLE person of my acquaintance has been arrested. And yet I and most of my friends use illict substances on a regular basis. Some of them deal drugs. Some have done so for years.

Are we lucky? No, we're middle class. Generally, in this country, only the poor are made to suffer for their indulgence.

I've never been hassled even once of the thousand or so times that I've bought smack on Vic St, because I just "don't look like a junkie". Although if the cops are doing one of their periodic, moronic sweeps, I do make sure I score at least a hundred metres form where they are. Ha ha ha -- it's funny because it's true.

The drug laws are unenforcable. Hence, they are capricious. Is there not some legal principle/ethical guideline that against that kind of thing?

I agree the Greens have chickened out. But I understand the need to become more acceptable by moving more to the centre and I hope that once they gain more public support, they can then implement real drug law reform. What I don't like though is that some Greens are backing the "cannabis is evil" rhetoric. Leave that to the other nutters.

Your point about drug users and small time dealers going to jail also irks me. Much of the public think jail is a holiday which is just mental. People do get raped and bashed. Jail can be hell but the incredible violence and sexual assaults are just allowed to go unchecked.

How many people do I know who have gone to jail? Let me count! There are more than a few. The difference is - I'm from Footscray!

I have had a couple of run ins with the police but I am typically left alone. I've never been arrested although there is usually smack in my pocket & fits in my bag. Although the feminist in me cries when I say this... I don't look like a junkie (well, not a Footscray junkie) and a short shirt and flash of a smile has saved my ass a number of times. Plus - I am white! There have been a number of times where police have done a street sweep & I am the only person allowed to walk away without anything but a wink from a white police officer.

I also use more drugs than the majority of people I know who have been locked up. They are poor. How much drugs do you think they can afford?!

When George Michael crashed his car, he was described as looking intoxicated. The guy had hit his head and was showing all the symptoms of concussion. Profuse sweating: since when has that been a symptom of cannabis intoxication? Sounds like our police as off the ball as yours. When it SUITS them.

Please, if you would, add something about the Australian heroin drought. There's already 30something comments there. Did it ever get that bad down your way, if so for how long and although this drought was said to have gone on (by the media) for years, how bad actually was it most of the time. Surely things levelled out after a period of time. But ukh, how long. People going mental, spending money on literally nothing, bc there's very very little in some batches, nothing at all in others, something else in yet others. Nasty

I am/was a pretty hard ecstasy user before the government ruined it for us and about 75% of other users here in Australia.

do i walk around starting fights, spewing my guts up and screaming my lungs out, no... thats the rest of the population that prefer to support the governments tax and over do it on alcohol.i prefer and always will, buying a pill, testing the active ingredients with a set of pill testers, verifying that the substance is mdma (which is rare now thanks government) take the pill and have a night full of euphoria and not have to spend over 100 dollars on alcohol, fund the government and wake up with a hang over.

in saying that i do understand ecstasy has its hang ups, with a proven study to become neurotoxic it has the stigma of producing negative mentall health effects.moderation + body nourishment = minimal neurotoxic side effects. i heavily used ecstasy for 24 months most weekends and i still have all my teeth, a iq of 116, quite sexy and have a very open appeal to life, i even have a job. i dont have holes in my brain or live in a gutter, and no this battery acid and crushed glass they '''find''' at lab set ups hasnt hurt me either

i write this, cause i agree with this post top to bottom, people touch drugs and people like drugs, almost like the government likes money and the press love bullshit.

Good points about George Michael. BTW, I am a huge George Michael fan. Faith is one of my favourite CDs of all time.

The supposed heroin drought is really just levels going back to normal after an explosion of cheap, high quality gear that flooded Australia around 1997-2000. The "drought" is just our previous government trying to claim that their great policies and policing somehow reduced the amount of heroin in Australia. What they didn't tell us was that heroin levels dropped everywhere that was supplied by SE Asia. SE Asian drug cartels had simply switched to Ice and ecstasy instead of heroin. The head of the Australian Federal Police admitted this years ago.

The Australian Heroin Diaries has been chosen as one of the top 8 blogs in 2009 by AllTreatment.com:

This is a news driven blog, that writes about and commentates on different countries drug policies. The author is a recovering heroin addict which gives a unique view and a much different one from politicians on drug politics. A must read for anyone interested in the politics of drug use and substance abuse.